There is an argument to make for 240V being a little less expensive to operate (besides the transmission losses). It depends on the size / power rating of the spa and how you use it.
To illustrate it, I'll use my spa. I ran a 50A 240V circuit to it. When the heater is on and the pump is running full out (it has a 2 speed motor), I have measured the amp draw at about 40A. If that were a 120V circuit, it would be 80A so it would need to be a 100A circuit. If I'm not mistaken, I don't think you can buy a 100A 1 pole breaker; I think 70A is the biggest. So if it were 120V, they would need to use a smaller heater element. If the heater element is smaller, it will still heat up the water, but it will take longer. So technically, the same net amount of kWH would be used to heat up the same amount of water to the same temperature.
BUT, you also have to look at how the spa is used. I do not keep mine at full temperature all the time. I keep it as low as it will go (80F) and turn it up in advance of using it. So for my purposes, I want it to heat up as fast as it can.
The final step in this is to know how spas work as well. For most spas, if the heater element is on, the pump MUST be on with it, otherwise you damage the heater element. So if the heater takes longer to heat up the water, the pump is going to run longer as well, which WILL make it consume more energy if run at 120V. To be fair though, if you ALWAYS keep it on at full temperature, that will not be as much of an issue because maintaining temperature is a lot different than raising temperature.